Community Living Options INC

NPI #1922270057 in Wood River, Illinois

Provider Information

NPI Number
1922270057
Entity Type
Organization
Organization Name
Community Living Options INC
Subpart
Yes (part of a larger organization)
Parent Organization
COMMUNITY LIVING OPTIONS INC
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Mar 28, 2008
Last Updated
Apr 20, 2008

Practice Location

Address
330 LINTON AVENUE
ZIP Code
62095-3257
Phone
(618) 258-1212

Authorized Official

Name
MR. RONALD J WILSON
Title
AUTHORIZED AGENT
Phone
(309) 343-1550

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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